Individual
JESSICA LYNETTE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, LMHP, CMSW
Contact information
Practice address
11204 DAVENPORT ST STE 200, OMAHA, NE 68154-2658
(402) 356-3332
Mailing address
11204 DAVENPORT ST STE 200, OMAHA, NE 68154-2658
(402) 327-1444
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3326
NE
104100000X
Social Worker
Primary
2846
NE
1041C0700X
Clinical Social Worker
2246
NE
Other
Enumeration date
10/02/2023
Last updated
08/06/2024
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